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Organization
PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION, LLC.
Active
Organization
PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEIL LEON MICNHEIMER D.C. (SOLE OWNER)
(618) 690-5100
Entity
Organization
Contact information
Practice address
122 S 2ND ST, GREENVILLE, IL 62246-1723
(618) 690-5100
(618) 690-5101
Mailing address
504 S 6TH ST, NEW DOUGLAS, IL 62074-1622
(618) 690-5100
(618) 690-5101
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038013077
IL
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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